Articles about Maternal Healthcare

Tikil Dingay Health Center, one of the main facilities serving the district, had discontinued comprehensive abortion care services for over two years following the turnover of trained providers due to the Northern Ethiopia Conflict. The absence of skilled personnel meant that women and girls were left with few options often resorting to unsafe and unregulated procedures that endangered their lives. Unsafe abortion continues to be one of the leading causes of maternal deaths in Ethiopia, with 42% of unintended pregnancies ending in abortion nearly 73% in unsafe conditions. The two-and-a-half-year conflict in northern Ethiopia, particularly in Amhara, has worsened the situation by disrupting health services and increasing adolescent vulnerability to unplanned pregnancies and unsafe abortions. The ongoing efforts under the WISH 2 project to restore and strengthen safe abortion services in Lay Armachiho in Amhara region therefore represent a critical intervention to safeguard women’s and adolescents’ reproductive health and rights, rebuild community trust in health facilities, and reduce preventable maternal deaths. To address this urgent gap, the Family Guidance Association of Ethiopia partnered with the Woreda Health Office to assess the facility’s capacity and design an intervention to restore services. The assessment confirmed that while the health center served a large catchment population, it lacked trained staff and essential supplies to deliver safe abortion care. In response, FGAE organized a 17-day Comprehensive Abortion Care training in Addis Ababa for selected healthcare providers, in line with Ministry of Health standards. Among the trainees was Dr. Solomon Adugna from Tikil Dingay Health Center, who upon completing the training, returned to the facility and immediately began mobilizing his colleagues to reinstate the service. The center allocated a dedicated room for CAC, procured necessary supplies including abortion kits, medications, and registration materials and established a routine supervision and mentorship system to ensure quality and accountability. “After completing the training, I was determined to ensure no woman in our community would suffer or die because she lacked access to safe care. We quickly organized our team, prepared the room, secured supplies, and restarted the service with full accountability,” — Dr. Solomon Adugna, Tikil Dingay Health Center Within just four months of resuming services, 19 women and adolescent girls accessed safe abortion and post-abortion care, including counselling, HIV testing, and family planning. Though modest in number, these cases represent lives saved and health restored tangible evidence of the transformative power of capacity building and local leadership. One of the clients, a 19-year-old girl, recounted her experience: “I was very worried. The private clinic requested me 6,000 Birr (which is equivalent to 40$) for the service. While searching for other traditional alternatives, one of my colleagues told me the health center provides the service. Anyway, they saved my life.” The success of this intervention was not without challenges. Frequent staff turnover and technical gaps had disrupted service continuity for years. However, through close collaboration between FGAE, the Woreda Health Office, and Tikil Dingay Health Center, these challenges were effectively mitigated. Plans are now in place to assign dedicated staff and expand training opportunities for additional providers, ensuring sustainability and continued access to safe services.  

Nestled along the southern shores of Lake Kariba, Sinazongwe District is one of Zambia’s most remote areas. Many of its communities are scattered across hilly terrain and along the lakeside, where accessing health services can mean walking several kilometres under the scorching sun. For young women and adolescents, especially those who are unmarried, the journey to seek family planning services can be even more daunting due to stigma and lack of privacy. In Zambia, only 48% of married women aged 15–49 use modern contraceptive methods, and 20% of married women still have an unmet need for family planning. The situation is often worse in rural and hard-to-reach districts like Sinazongwe, where health facilities are far apart and social norms limit young women’s access to contraception. It is within this challenging context that the WISH 2 project, in partnership with local health authorities and WISH 2 implementing partners, has been working to expand access to modern contraception through community outreach. One of the most transformative interventions has been the introduction of Sayana Press, a self-injectable contraceptive that women can administer privately and conveniently. While Zambia may not yet have a fully formalised, standalone National Self-Care Framework for SRHR, there are emerging toolkits and policies supporting self-care in SRHR.   “Young people can easily access Sayana Press during outreach and unmarried girls prefer it because it’s discreet, no one needs to know they are using contraception,” explained Elector Siyapwaya, a Community Health Worker in Sinazongwe health facility. “When I teach a young woman to use Sayana on her own, I feel proud. It means she can plan her life without fear,” added Siyapwaya. In Sinazongwe District, family planning services were integrated within the Well-Baby Clinic, where mothers bring their infants for routine weighing and growth monitoring. Through this platform, healthcare workers also provide SRHR awareness and FP counseling on modern family planning methods. Women can receive methods covering three to one year, reducing the need for frequent clinic visits. This approach reduces the burden of long travel to health centers and makes reproductive health services more accessible to all. “As a young married woman, I used to forget to take my pills. Now, with Sayana Press, I just take one injection every three months. It’s easy, and I can do it myself or if I need assistance, CHVs are there,” shared Mwila, a 24-year-old mother of two. Despite these successes, challenges remain. Privacy during outreach is still an issue, as most sessions take place in open spaces without tents or designated service corners. “It’s difficult to ensure privacy when providing services in public spaces. Sometimes young women hesitate to approach us because others might see them,” said Siyapwaya. To address this, WISH 2 partners have invested in training Community Health Workers and Volunteers on both the administration of Sayana Press and client confidentiality to teach women how to safely self-inject, empowering them to manage their own reproductive health and promoting self-care. This community-based model is showing promising results, and the impact is visible. More young women are now choosing self-injectables, appreciating their convenience and discretion. For those living in remote or conservative areas, Sayana Press represents more than a contraceptive, it embodies control, choice, and dignity. Convenient, private, and requiring no frequent clinic visits, it offers women greater autonomy over their reproductive health. As outreach services continue to extend to the most isolated parts of Sinazongwe, Sayana Press is proving to be more than a method, it is a symbol of empowerment, helping young women take charge of their health and futures, even in Zambia’s most hard-to-reach communities.  

Under the Evidence project, IPPF is undertaking innovative research on respecting, protecting and promoting human rights in family planning/reproductive health services and ensuring community voices are part of efforts to improve and strengthen family planning programming. The Evidence Project uses implementation science to improve family planning policies, programs, and practices. Led by the Population Council in partnership with INDEPTH Network, International Planned Parenthood Federation, PATH, Population Reference Bureau, and the project’s University Resource Network, the five-year project (2013–2018) is investigating which strategies work best in improving, expanding, and sustaining family planning services. IPPF is leading on two cross-cutting areas of research. Firstly under the Evidence project, we are undertaking research on how the respect and protection of human rights of women and girls can be instituted and operationalised, and how programs can be held accountable for providing high-quality services. http://evidenceproject.popcouncil.org/technical-areas-and-activities/equity-rights-and-accountability. In order to address the need for indicators and tools for rights based family planning, the Evidence Project has partnered with global experts on human rights and family planning, the International Planned Parenthood Federation’s Sustainable Network Project (SIFPO/IPPF) and with colleagues at Reproductive Health Uganda (RHU) to develop and validate the Rights-Based Family Planning (RBFP) Service Delivery Index in Uganda. This is work is being undertaken in close collaboration with the Economic Policy Research Centre Uganda and University College London.  In addition, we are undertaking a variety of activities that aim to contribute to a deeper knowledge of whether and how the implementation of accountability mechanisms in family planning and reproductive health programs improves clients’ access to and quality of services.   For example, a multi-site case study in Uganda uses process evaluation methodology to explore the implementation of two social accountability programs, aiming to determine what hinders and facilitates engagement at the community level and its translation into improved social accountability processes and reproductive health outcomes.   http://evidenceproject.popcouncil.org/accountability-mechanisms-to-improve-family-planning-and-reproductive-health-programs/  

This programme addresses critical challenges faced by young women around sexual health and sexuality. It has produced a range of advocacy, education and informational materials to support research, awareness-raising, advocacy and service delivery.    Girls Decide is about the sexual and reproductive health and rights of girls and young women. Around the world, girls aged 10 to 19 account for 23% of all disease associated with pregnancy and childbirth. An estimated 2.5 million have unsafe abortions every year. Worldwide, young women account for 60% of the 5.5 million young people living with HIV and/or AIDS. Girls Decide has produced a range of advocacy, education and informational materials to support work to improve sexual health and rights for girls and young women. These include a series of films on sexual and reproductive health decisions faced by 6 young women in 6 different countries. The films won the prestigious International Video and Communications Award (IVCA). When girls and young women have access to critical lifesaving services and information, and when they are able to make meaningful choices about their life path, they are empowered. Their quality of life improves, as does the well-being of their families and the communities in which they live. Their collective ability to achieve internationally agreed development goals is strengthened. Almost all IPPF Member Associations provide services to young people and 1 in every 3 clients is a young person below the age of 25. All young women and girls are rights-holders and are entitled to sexual and reproductive rights. As a matter of principle, the IPPF Secretariat and Member Associations stand by girls by respecting and fulfilling their right to high quality services; they stand up for girls by supporting them in making their own decisions related to sexuality and pregnancy; they stand for sexual and reproductive rights by addressing the challenges faced by young women and girls at local, national and international levels.

The Japan Trust Fund for HIV and Reproductive Health is built on the three pillars Maternal, Newborn and Child Health.  i.e. Reduce child mortality and improve maternal health by strengthening health systems through use of EMBRACE approach Infectious Diseases: HIV/AIDS, tuberculosis and malaria: Scale up effective interventions through the Global Fund to fight against HIV/ADIS, tuberculosis and malaria. Public Health Emergencies: Provide support to respond to global public health emergencies and health crises due to natural disasters and conflicts, thereby contributing to peace-building and community stabilization In Africa the fund is granted to programmes in Kenya, Lesotho, Rwanda, Ghana, Swaziland, Zambia and Senegal where we deliver mother to child health services through the EMBRACE model increase access to sexual and reproductive health services to most vulnerable women and girls including post conflict/emergency settings promote innovative service delivery models for SRHR and HIV services (sometimes in partnership with the Japanese multinational companies) JTF allocated funds for M&E and capacity building as one of the priorities of the initiative is to increase capacity of Member Associations on new thematic areas as well as develop innovative service delivery models. The projects are operational for a maximum of two years.   

Ntsetselelo Manzini's story. "Three years ago when I was down with HIV, I had lost all hope. My body was weakening and it seemed that it was not going to be easy for me to go on with life. A friend told me about the Family Life Association of Eswatini (FLAS) and their services. Now at 27 years old, the future looks very bright, and I see myself achieving my goals, thanks to the care, treatment, and support I have been receiving from the FLAS clinic. It all started a few years ago when a Medical Officer at the Association’s clinic noticed that my CD4 cells (immune cells that fight off infections) were low. He said I should start the antiretroviral therapy immediately to prevent me from slipping into the AIDS stage. The reception I received from the staff was very warm. I felt wanted, special and cared for. The counsellors and nurses were very friendly and very welcoming. They listened to my story, gave me rich and useful advice and encouragement, which made me feel better. One of the things I’ve noticed was that the care providers were very nice to everyone. Here I felt respected and valued. This led me to bring one of my children to FLAS for an HIV test. She was found to be HIV negative. The hope I had lost in living got a renewed strength. There is one thing that I like about FLAS clinics: you can discuss anything with the service providers with openness and trust. Unlike other clinics, confidentiality is always maintained. I just feel comfortable whenever I walk into a FLAS clinic. This is the best thing that happened to me in the past three years. Thanks to the high quality and comprehensive services I received there, I have referred a lot of people to the association’s antiretroviral therapy clinic. These people include my brothers and friends who are either infected or affected by HIV. The information I get from FLAS also enables me to help others. For example, I have an uncle who is taking his antiretroviral drugs and relies on me for up-to-date information on antiretroviral treatment, which helps him a lot in terms of proper management of the disease. My wife, who is also HIV positive, is soon going to start receiving her treatment from FLAS after she witnessed how the clinics treat its patients. I believe that the care received at the FLAS clinic was the intervention that helped me stay alive . I am who I am now thanks to the clinic. The renewed hope in me and the energy to be productive again is attributed to the services I receive from FLAS. This is the reason why I always pray that their services continue to be available to poor people like me to keep enjoying life."  -Ntsetselelo Manzini.  For more updates on our work, follow IPPF Africa Region on Facebook, Twitter, Instagram and You Tube.

Rostina Pedro Cumbane is a 35 year-old person living with disability (PLWD) and single mother of three children aged 8, 10 and 13 years. She lives in Maputo, Mozambique’s capital city, and plaits women’s hair in a room in her house - her family’s sole income.  Widowed five years ago, Rostina says that while she has been dating, she is yet to find someone she wants to settle down with. Since she doesn't want to have an unplanned pregnancy, she has been going to Associação Moçambicana para Desenvolvimento da Família (AMODEFA), the local IPPF Member Association health center for family planning services, run as part of  the Women's Integrated Sexual Health (WISH2ACTION) program, which is funded by the UK Government under the ethos of ‘Leaving No One Behind’.  The WISH2ACTION programme offers integrated and inclusive family planning and sexual and reproductive health (SRH) services to marginalised and hard to reach populations: the poor, youth under 20, and persons living with disability.  Hearing impaired since birth, Rostina accesses a wide range of services at the AMODEFA clinic in Maputo. Recently, she undertook a HIV test and received a top-up of family planning pills during her regular scheduled appointment.   "I’m leaving here happy because the result (from the HIV test) is negative. This means that the protective measures I have been taking are working," said Rostina, through nurse Rufina Joaquim who interpreted her sign language.   Rostina additionally requested for male condoms to give her partner should he forget to bring some at their next encounter.   "I am very strict about this because I don’t want to have any more children unless it's with a person I trust entirely and with whom I and can make future plans with," said Rostina. "For now, my priority is to educate my children.”   Rostina expresses gratitude towards AMODEFA and recommends that the organization’s services be expanded to other parts of the country where they can reach more women with disabilities, who oftentimes are victims of violence but are not always able to express themselves. SRH Challenges for Persons Living with Disability Some of the SRH challenges that AMODEFA has observed regarding PLWDs’ access to services include: the lack of public health policies that support their access to SRH services, stigma and discrimination (including at facility level) of those who seek services, as well as poor infrastructure at service delivery points, which makes it especially difficult for PLWDs to access these services. From AMODEFA’s experience and subsequent recommendations, it is important to involve Organizations of Persons with Disabilities (OPDs) in inclusive sexual reproductive health and rights (SRHR) capacity building initiatives. This would increase healthcare workers’ outreach to PLWDs and would also help PLWDs learn more about SRH services and their availability. AMODEFA continues to scale up SRH services by facilitating awareness-raising sessions and dialogues on family planning myths and misconceptions, more so among persons living with physical disability and those who are hearing-impaired. Also read: "My Attitude Towards Persons with Disabilities is Different Now"-Mazza, Ethiopia. For more updates on our work, follow IPPF Africa Region on Facebook, Twitter, Instagram and You Tube.

By Maryanne W. Waweru Tewodros Kassa is a 27-year-old journalist from Ethiopia, currently a reporter with the Ethiopian Herald. A holder of a BA degree in journalism and communications, Tewodros chose health journalism as his specialty. In this article, he shares his experiences as a health reporter, more so during this time of the COVID-19 pandemic. Tewodros is also a member of the IPPF Africa Region SRHR Journalists' Network.  Why did you choose to be a journalist? I chose journalism because I wanted to positively contribute to society by sharing information through telling powerful stories. I observed that many people faced difficulties in life due to lack of proper information, especially that related to their health. I wanted to fill this gap by empowering them with information that would enable them to make healthy decisions about their lives. Why did you choose to specialize in health journalism? I particularly chose health journalism because good health is critical to our survival and well-being. However, there remains a wide information gap when it comes to health. While there are so many important health issues to be covered, in Ethiopia, many media houses prioritize politics, business, and other agendas, with minimal space being given to health. My desire has always been to change this by advocating for more coverage of health issues and mobilizing policy makers and other stakeholders’ commitment towards a healthier society through well-told stories. Where do you get your stories from? I like reporting from a human-interest angle. This involves interviewing ordinary people in the field. Reporting this way helps my readers connect with the story better. Data and lengthy reports filled with jargon from scientists, researchers, medics and policymakers are best interpreted and told through the stories of individuals -the human-interest angle, and that is what I do. What is your daily routine like as a health journalist? Every morning, I make sure I catch up with global and local news as I keep myself updated. I then try to develop story ideas based on the health issues of the day. I also finish any pending stories I was working on. I am constantly in touch with my sources –who include health care professionals, patients, researchers and scientists as they are the ones who give me new information and help verify facts in their areas of expertise. Which is the most memorable story you have ever filed? It has to be the story I did titled “The covert life of Eskedar”. This was the story of a 35-year-old woman living in rural Ethiopia, and whose education was interrupted when she was married off at the tender age of 10. She went on to face abuse in her marriage, which she eventually left. In her struggle for survival, she ended up on the streets as a commercial sex worker, where she faced a myriad of challenges including sexual violence, harassment and exposure to sexually transmitted infections (STIs) including HIV. Eskedar’s story inspired me to continue doing more reports that highlight issues of poverty, child marriage and the need for education of the girl child, as well as women’s empowerment.   What have some of your experiences been during COVID-19? My reporting experience during Covid-19 has no doubt been challenging. Staying at home and working from home is difficult as a journalist, especially when your work largely requires you to go out to the field to collect information. Restrictions on movement have affected our regular group discussion forums, attending of conferences and other public forums -all of which are platforms for harvesting good story ideas. However, conducting telephone interviews, use of social media and other digital technologies have allowed me to succeed in my reporting during the pandemic.  Social media has been of great benefit to me when reporting during COVID-19. I have attended many press conferences, webinars, conducted interviews and followed live proceedings of reports and briefings via social media. Besides, social media is faster than the mainstream media when it comes to disseminating stories to the public. I can also say that adhering to the stipulated COVID-19 safety mechanisms have helped me stay safe. I wear my face mask as required, washing hands properly, sanitize, stay home when it is necessary, and I observe social distancing while out there. How have you worked with IPPF’s Member Association during this time? Family Guidance Association of Ethiopia (FGAE) has over the years played a supportive role for me as a journalist – something it has continued to do during this time of COVID-19. As I’m collecting information, FGAE always helps me find the right person for the interview, generate new ideas, access experts for my story, access data and other resources, among others. FGAE has helped me over the years in my health reporting. Tewodros spoke to Maryanne W. Waweru, Communications Officer, IPPF Africa Regional Office For more information about the work of IPPF Africa Region, connect with us on Facebook and Twitter. 

The IPPF-led Women’s Integrated Sexual Health, W2A programme, under the banner ‘Leave No One Behind’ offers quality integrated and inclusive family planning/sexual reproductive health (FP/SRH) services to marginalized and hard to reach populations such as the poor, youth under 20 and people with disability. The programme enhances disability inclusion efforts to deliver high-quality integrated sexual reproductive health and rights (SRHR) services and counselling by working closely with consortium partners to tackle stigma and improve healthcare access for people living with disabilities (PLWDs) both at the national and community levels in the W2A countries. Ethiopia disability prevalence stands at 9.10% and as such, strengthening disability inclusiveness in service delivery has been a focus of IPPF’s Member Association in Ethiopia -Family Guidance Association of Ethiopia (FGAE) and WISH2ACTION partners in the country -Humanity and Inclusion (HI) and International Rescue Committee (IRC). This work is advanced through context analysis to identify barriers to access for people with disabilities, mapping national-level disabled persons organizations, (DPOs ) and actors working on the theme of rights of people with disabilities as well as training service providers in inclusive SRH (iSRH). “I am Mazza, a 25 year-old nurse in Gambela. Having graduated from college as clinical nurse, I have been providing family planning/ sexual and reproductive health services at a local hospital.  For years, I would face challenges when persons living with disability (PLWD) came for health services at the hospital. My greatest challenge was how to best communicate with them in order to understand their health needs and offer quality services. I was particularly surprised when they came for family planning services as I didn’t think PLWDs are sexually active, and that they too need family planning services. In March 2020, I participated in a training organized by the WISH2ACTION programme. The five-day training was on ‘disability-inclusive SRH service delivery’. Interestingly, on the first day of training, I took a pre-test and scored 30%. The test was to examine my level of knowledge and understanding of disability and SRH service delivery to this population. However, on the last day of the training I scored 80%! Indeed, I gained a lot of new information and skills during the training.  From the training, I understood that persons with disability have the same sexual and reproductive health needs as those without disabilities. Additionally, I learned about how to best communicate with them, and how to provide disability-friendly services that can help them overcome the barriers they face in accessing quality health services.  The training further enabled me to change my mindset about PLWDs, and have an improved outlook about them and their needs. They too have needs and rights that must be respected. Since attending the training, I have developed more interest in issues of disability, and my commitment to ensuring PLWDs receive quality SRH services has been strengthened. I want to thank the WISH2ACTION project for their work with PLWDs. We will achieve even greater milestones if such training opportunities are availed to all health workers. This will enable them to provide disability-inclusive quality SRH services.” For more information about the work of IPPF Africa Region, connect with us on Facebook and Twitter. 

​​​​​​Today, the International Planned Parenthood Federation Africa Region (IPPFAR) joins the rest of the world in marking the International Youth Day under the theme ‘Youth Engagement for Global Action’. We asked some members of the Youth Action Movement (YAM), a youth arm of IPPFAR’s volunteer body to share their perspectives on youth engagement. This is a conversation with Erasmo Mbemba, YAM member from Family Planning Association of Malawi (FPAM). In your opinion, what does meaningful youth engagement mean and why is it important?   Erasmo: Meaningful youth engagement means treating young people as colleagues and equals. To me, young people need to be part of all processes from the beginning to the end. These processes include planning, decision-making, implementation, monitoring and evaluation. Young people should have the same rights as everyone else, such as the equal right to speak and contribute to all processes without being undermined. This helps to build their confidence and groom capable and experienced leaders. How has IPPFAR and your Member Association fostered youth engagement? Erasmo: IPPFAR and Family Planning Association of Malawi (FPAM) are doing a lot to ensure meaningful youth engagement. They have created a platform where young people are a part of the governing bodies, Board of Trustees at regional, national and district levels. They have invested in building the capacities of young people, thus enabling them to effectively contribute to both organizations. IPPFAR and FPAM have created spaces where young people can meet and discuss issues affecting them, while at the same time engage adult mentors to help them grow as individuals and teams. I am a beneficiary of all these processes.     How can young people be more involved in decision-making processes?  Erasmo: There is need to invest in more capacity building initiatives for young people through trainings and mentorship programs, because if young people lack information and skills they may not contribute effectively even when included in all processes and spaces. Capacity building and creating opportunities for young people to take up high-level leadership roles in an organizations (NGOs), private sector, political, community and religious institutions will help to speed youth engagement. Also Read: "My Volunteer Work Enabled me to Travel Outside my Country" -Michelle Grace Phiri If you are young person and would like to join the Youth Action Movement, see where we work and get in touch. You can also reach us through @YAM Africa For more information about the work of IPPF Africa Region, connect with us on Facebook and Twitter.